Many people say “I hate change”. I think most people hate change! No one has a corner on the market on hating change. Yes, of course, there are a few people who really love and welcome change, but there aren’t many.
When we are working with clients/patients who resist change and we wonder why, try remembering how you feel when you are asked or expected to change. I find that clinicians learn the principles and techniques of MI best when they apply the ideas to themselves. After all, we are all patients at one time or another.
To help you understand how your patients might feel about change. Think of something in your life that you
- Have been thinking about changing;
- Someone else thinks you should change;
- You think it would be a good idea to change;
- But you haven’t changed yet.
What’s keeping you from changing? The unknown? What you would do instead? That you would miss something you love to have/do/eat, etc? Even if it’s something you know you’d be better off if you changed, it’s still can be hard to do. Note that wanting to want to change is not the same as being ready to actually do it.
Now, think about whether you
- Really want to change and
- Are able to change.
You might find that, just like your clients/patients, you might want to and not be able to, or not even want to. Thinking it’s in your best interest isn’t the same as being ready to change. I often suggest to my clients that feeling guilty about not making the changes is not useful, and just wastes energy. Perhaps this change isn’t something you will do right now, but sometime in the future.
When people are in the space where they think they should change but aren’t changing, that’s ambivalence, a key idea in Motivational Interviewing. Ambivalence is good, not something to talk people out of. Ambivalence means you are not saying “no, never”, you’re saying “maybe”. The job of the clinician using MI is to tip the balance of ambivalence in favor of positive change.
